| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN INC. | $31K | $0 | $31K | 2.22% |
| NONE | — | DELTA DENTAL OF CALIFORNIA | — | — | $0 | 0.00% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICE LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | $0 | $4K | 1.94% |
| NONE | — | UNITED HEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY | — | — | $0 | 0.00% |
| NONE | — | UNITED HEALTHCARE INSURANCE COMPANY | — | — | $0 | 0.00% |
| NONE | — | UNITED HEALTHCARE OF CALIFORNIA | — | — | $0 | 0.00% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INSURA | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $2K | $0 | $2K | 9.17% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICE LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | VISION SERVICE PLAN | $216 | $0 | $216 | 0.83% |
| MCGEE & THIELEN INSURANCE BROKERS3 Filed as: MCGEE THIELEN INS BROKERS INC. | 3840 ROSIN CT #245 SACRAMENTO, CA 95834 | STANDARD INSURANCE COMPANY | $1K | $0 | $1K | 9.52% |
| EMERSON REID LLC3 Filed as: EMERSON REID AND CO INC | 669 RIVER DRIVE SUITE 305 ELMWOOD PARK, NJ 07407 | STANDARD INSURANCE COMPANY | $553 | $0 | $553 | 5.00% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 575 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 575 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 168 | $1.6M |
| Dental | DELTA DENTAL OF CALIFORNIA | 312 | $227K |
| Vision | VISION SERVICE PLAN | 181 | $26K |
| Life insurance | STANDARD INSURANCE COMPANY | 207 | $11K |
| Prescription drug | UNITED HEALTHCARE INS. CO. AND UNITEDHEALTHCARE NY | 32 | $151K |
| Other | UNITED HEALTHCARE INSURANCE COMPANY | 32 | $109K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 312 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
No prospect flags tripped on this filing.